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General NPI Number Information
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NPI Number | 1043931827
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Entity Type | Individual
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Provider Name | SKY JAZEL MCINTYRE AUD
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Gender | Female
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Dates
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Enumeration Date | 09/08/2022
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Last Update Date | 09/08/2022
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Provider Practice Location Address
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Address Line | 1245 WILSHIRE BLVD SUITE 100
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City | LOS ANGELES
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State | CA
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Zip | 90017-4801
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Country | US
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Telephone | 213-483-9930
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Fax |
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Provider Business Mailing Address
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Address Line | 1245 WILSHIRE BLVD STE 100
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City | LOS ANGELES
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State | CA
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Zip | 90017-4801
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Country | US
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Telephone | 916-307-9590
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 3735
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License Number State | CA
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